My wife and I live in an assisted living facility. I am 71 and am nonambulatory due to a rare muscle disease, inclusion body myositis. My wife is 65, also in a wheelchair from myotonic muscular dystrophy and suffers from dementia (most likely Lewy Body Dementia) and psychosis. We have been unable to get a firm diagnosis because she also has stageIV chronic kidney disease which prevents the use of contrast media for brain imaging. However her symptoms would seem to point toward LBD.

Her first symptoms were hallucinations which began late last year while we were still living in our own home. They mostly involved wild animals outside and spiders inside, and a delusion that I was sleeping with our caregiver. She would roll over in her bed and point at me (in my hospital bed, wearing my CPAP, unable to move) and hiss "How can you deny she's not in bed with you?" Ever since we moved to the assisted living facility 3 months ago, her hallucinations and delusions have taken on a complex and frightening story line. She believes there are people living here who are out to punish her and our family because (she thinks) she allowed one of their children to be eaten by tigers. Her hallucinations include a vast cast of characters - an Indian tribe, dozens of onlookers, police, numerous lions, tigers, bears, snakes, and even a kangaroo. She believes she is being shot with arrows and is having disfiguring medical procedures performed on her.

In the past few days, she has seen her daughters and grandchildren attacked, molested and seriously injured and, in one case, killed. She spent an entire night grieving over the loss of our child. She is constantly demanding that I take action or that caregivers take action. She wants us to call the police, kill snakes and scare off tigers etc.

One evening she was convinced her sister was visiting and that we had to bring in an extra bed for her. I got her sister on the phone who told my wife she was 1500 miles away in her home state. Afterward, my wife put down the phone and told me she had to go tell her sister that she isn't here.

Last night her sister was hanging from a tree and my wife wanted us to cut her down.

She keeps demanding that the owner of the facility kick out the trouble-making family.

Our children want her placed in a secure memory care facility, but then we would be separated and we can't afford two separate places anyway.

I can't find anyone who can advise me how to deal with all this. The neurologist doesn't want her to take any antipsychotic medicine because he suspects LBD, but he doesn't have to deal with the behavior issues. Her geriatric psychiatrist has prescribed risperidone because she believes the symptoms are more psychotic than from dementia. In fact she says this is the worst case of its type she has ever seen.

I read that I'm supposed to "go along" with her delusions but often it is physically impossible for me to even pretend to do what she wants (haul away tigers, kill snakes, hide nonexistent guns) since I can't walk and my hands nearly paralyzed.

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